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患者男性,49岁。因剑突下隐痛不适3年,加重并黑便4天,以上消化道大出血于1994年4月24日收入院。腹痛与饮食无明显关系,无反酸嗳气等症。4天前因进食较烫食物后腹痛加重,解柏油样稀便,量多,伴心慌:乏力、恶心,无呕血。查体:T 36.8℃,P94次/分,BP13/9kPa,面色苍白,剑突下有轻度的压痛,未扪及肿块。Hb 64g/L,OB(++++)。入院后每日仍解1—2次黑便,量约500g,Hb降至50g/L。经输血1200ml及补液止血等治疗2周后出血渐少,行纤维胃镜检查示:十二指肠大弯侧粘膜可见2.0×2.0cm向腔内突出的新生物,中央有糜烂,诊断十
The patient male is 49 years old. Due to the discomfort of xiphoid subtle pain for 3 years, aggravated and mellow 4 days, the above gastrointestinal bleeding was admitted to the hospital on April 24, 1994. There was no obvious relationship between abdominal pain and diet, and no signs of reflux acid reflux. 4 days ago due to eating hot food after abdominal pain increased, solution of tar-like thin stool, quantity, with flustered: fatigue, nausea, no vomiting. Physical examination: T 36.8°C, P94 beats/minute, BP13/9kPa, pale, mild tenderness under the xiphoid, no palpable mass. Hb 64g/L, OB (++++). After hospitalization, it still resolves 1-2 black stools per day, the amount is about 500g, and Hb drops to 50g/L. Hemorrhage became less after 2 weeks of blood transfusion and hemostasis after rehydration. The results of fiberoptic gastroscopy showed that 2.0 x 2.0cm of new tumors protruding from the large duodenum side of the mucous membrane protruded into the lumen, and there was erosion in the center.